Diplomate, Board Certification of Emergency Medicine
Chairman, Department of Emergency Medicine Ma'ayenei Hayeshua
Hospital
One of the tremendous miracles of our body is the fine-
tuning. Insulin, a hormone we discussed earlier which is
involved in sugar uptake into the cells, does not work
unopposed. A hormone called glucagon causes sugar release
from the cells and body stores into the blood stream. The
fine tuning between these two hormones creates an environment
which, under normal conditions, allows us to have the extra
sugar we need when we have a stressful event, while storing
sugars when things are calm.
Glucagon can be helpful in insulin oversecretion or in
insulin or tablets that increase insulin release overdose.
Here the blood sugar can fall dangerously low, and while
giving sugar such as a cup of orange juice is the usual
therapy, in an unconscious or vomiting patient giving
glucagon can be life saving. Glucagon also relaxes the valve
leading from the food pipe into the esophagus, so it is often
given for foreign bodies that are stuck in the food pipe. It
also gives a good push to the heart to make it work harder.
This property is useful in the overdose of many heart pills
which depress the function of the heart.
Just to conclude our discussion on sugar hormones, diabetes
can appear in pregnancy, which we will discuss another time,
bl"n. Pancreatic failure, such as in overuse of iron
supplements and alcoholism can also cause diabetes.
Another fine-tuning in the body is calcium release, which is
required in every cell. The parathyroid gland, four little
balls in the neck, is responsible for this, and the secretion
of PTH (parathyroid hormone) causes the body to bring calcium
into the blood stream and out of the bones and cells.
Another hormone, calcitron, causes the opposite effect. It is
also good as a nasal spray in reducing pain from osteoporosis
fractures. Too much calcium in the blood can be a result of
too much of this hormone, but it is rarely the cause. More
often, it is seen in cancer where bones are being broken down
by the cancer, an extremely painful condition. Too little
calcium in the blood is seen in PTH excess and in kidney
failure.
Calcium is commonly found in all dairy products, meats and
eggs. Calcium in pills may be from oysters and may be
unkosher. Dolomite, another source, is often laced with lead.
Be careful to buy supplements (if they are really necessary)
from reliable sources. Calcium alone is usually not enough to
treat or prevent osteoporosis.
Vitamin D is required for calcium absorption into the body.
In the USA, it is often put into milk, but the sun provides
us with most of the Vitamin D that we need in countries that
have a lot of sun, like Israel. Therefore, it is important to
make sure your children get enough sun by playing outside and
that they have calcium in their diet. Let me remind you that
Bamba and chocolate spread sandwiches do not provide enough
calcium! Write me in care of the Yated.
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